Treatment
Once renal artery stenosis has been diagnosed, you should be treated to prevent worsening of blockages, control blood pressure and protect your kidneys. Patients with renal artery stenosis are also at increased risk for heart attacks or strokes. Lifestyle changes and medications will not only lower your risk of permanent kidney damage, but also will decrease your chance of having a heart attack, stroke or peripheral vascular disease.
High blood pressure is treated by controlling the amount of salt consumed, avoiding certain over-the-counter medications such as cold medications or herbs that can raise blood pressure, and taking medications to lower blood pressure.
If you are experiencing an adverse reaction to your medications or having difficulty obtaining them, be sure to speak to your doctor about it.
The goal is to attain a blood pressure of less than 140/80 mm Hg or less than 130/80 mm Hg, specifically in those with diabetes or low kidney function. Your health care provider will advise you to avoid certain activities or lifestyle behaviors that may raise your blood pressure more. Avoid alcohol, smoking or energy drinks. If you are overweight, losing even a modest amount of weight can lower your blood pressure.
Eating a heart-healthy diet can help lower your cholesterol and stabilize plaques that are already established in your arteries. Use of certain cholesterol-lowering medications, called statins, have been shown to decrease the risk of permanent kidney failure and inflammation in the blood vessels. In addition, you should exercise regularly, control blood sugar and quit smoking.
For a minority of patients with renal artery stenosis due to abnormal cell growth in the blood vessel walls without cholesterol buildup (fibromuscular dysplasia or FMD), medical treatment involves lowering blood pressure and taking a blood thinner.
In rare cases, your provider may suggest a procedure to fix the kidney artery blockage with a catheter. If renal artery stenosis is causing heart failure, kidney failure or high blood pressure that is difficult to control with medications, you may be a candidate for a procedure in which a small metal tube called a stent is placed inside the blood vessel to open the blockage and improve blood flow to the kidney.
Prevention
In order to prevent RAS due to atherosclerosis, it is important to understand any pay attention to the factors that contribute to the development of the disease. Modifiable risk factors, in other words the risk factors that can be controlled, to prevent RAS include:
- Tobacco use: If you smoke tobacco, please consult with your health care provider about ways to quit. Use of any tobacco product increases your blood pressure and promotes the formation of plaques within the blood vessels. There are many aids, and even apps, now available to help you quit.
- Sedentary lifestyle: Be physically active and maintain a healthy weight. In general, individuals should participate in at least 30 minutes of moderate-level aerobic exercise per day at least five days per week.
- Diabetes: If you are unsure whether you have diabetes, speak with your provider about how to be screened. And, if you have diabetes, it is important to take steps to control your blood sugar by ensuring that your hemoglobin A1c is <7%. Elevated blood sugars over time can damage the inside of your blood vessels and lead to atherosclerosis.
- High cholesterol: Consult with your doctor to determine whether you need a lipid (cholesterol) panel. If you don’t reach your goal cholesterol number despite eating a healthy diet and exercising regularly, your doctor may prescribe lipid-lowering medicine, such as statins.
- Unhealthy diet: A healthy diet is an effective means of preventing atherosclerotic cardiovascular disease, including RAS. This includes: three-five servings of vegetables and two servings of fruit per day; two servings of fish high in omega-3-fatty acids per week; four handfuls of almonds and/or walnuts per week; use of healthy oils like olive and canola; and picking whole grains over refined.